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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ7781989; ADJ8262771
Regular
Oct 03, 2013

MIRIAN GARCIA vs. COOPER COLD FOODS, INC., ILLINOIS MIDWEST INSURANCE AGENCY as administrator for STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) is granting reconsideration of its own prior decision and rescinding a July 23, 2013 decision that had overturned a prior finding of 2% permanent disability for applicant's right knee injury. The WCAB determined that its August 9, 2012 order granting reconsideration was improvidently granted because the applicant had already filed a successive and improper petition for reconsideration. Consequently, the prior order and the subsequent rescinded decision are vacated, and the applicant's petition for reconsideration is dismissed.

WCABReconsiderationPetition for ReconsiderationFindings and AwardAdministrative Law JudgePermanent DisabilityIndustrial InjurySuccessive PetitionImprovidently GrantedVacated
References
4
Case No. MISSING
Regular Panel Decision
Jul 15, 1998

Claim of Baldo v. Daily News

This case involves an appeal from a Workers' Compensation Board decision setting the date of disablement for claimant Joseph Baldo, a former newspaper pressman who suffered from work-related lung cancer, as July 29, 1992. Baldo's widow filed for death benefits after his passing in 1994, leading to a dispute between workers' compensation carriers over liability. The appealing carrier contended that the disablement date should be earlier, citing diagnoses in 1990 or 1991. However, the court affirmed the Board's decision, emphasizing the Board's discretion in selecting a disablement date and finding no medical evidence to establish disability prior to July 29, 1992, even though earlier diagnoses existed.

Workers' Compensation LawLung CancerDate of DisablementAppellate ReviewSubstantial EvidenceCarrier ResponsibilityOccupational DiseaseMedical EvidenceClaimant DisabilityBoard Discretion
References
3
Case No. MISSING
Regular Panel Decision
Jan 08, 2014

Claim of Angela Page v. Liberty Central School District

The claimant, a school librarian, sought workers' compensation benefits in July 2004 for a disability from toxic mold exposure, leading to an established claim for hypersensitivity and awards for temporary total disability. In 2006, the claim was amended to include multiple chemical sensitivity, and awards for marked disability continued. A Workers’ Compensation Law Judge (WCLJ) later classified the claimant with a permanent total disability in March 2010, but the Workers' Compensation Board rescinded this finding and referred the matter to an impartial medical specialist, Theodore Them. Them testified that multiple chemical sensitivity is not a medically recognized condition and that the claimant had no causally-related disability, which the Board credited in its December 2012 decision, finding no further causally-related disability and closing the case. The claimant's subsequent appeal of this decision was not perfected, and an application for reconsideration was denied. An April 2013 WCLJ decision to further develop the record on disability was challenged by the employer, who argued the December 2012 Board decision had resolved the issue. The Board panel agreed with the employer in January 2014, precluding further development of the record, a decision which this Court affirmed on appeal, stating the issue of causally-related disability had been decided and the claimant's remedy was a timely appeal of the prior Board decision.

References
2
Case No. MISSING
Regular Panel Decision
Jul 22, 2002

Claim of Ostuni v. Town of Ramapo

Claimant appealed from a decision of the Workers’ Compensation Board, filed July 22, 2002, which denied her application for reconsideration and/or full Board review of a prior decision. The prior decision had ruled that claimant did not sustain a work-related injury, citing insufficient credible evidence. The appellate court affirmed the Board's denial, finding that the Board fully considered all evidence and no new, previously unavailable evidence was offered to warrant altering its decision. Furthermore, the court found substantial evidence supported the Board’s September 2001 decision that claimant’s injuries were not compensable, as her recurring lower back pain stemmed from injuries predating or following the alleged November 1990 incident, rather than the incident itself. The court also upheld the Board's rejection of contrary testimony as not credible.

Workers' CompensationBack InjuryWork-Related InjuryReconsiderationBoard ReviewAppellate ReviewAbuse of DiscretionArbitrary and CapriciousSubstantial EvidenceMedical Testimony
References
5
Case No. 2015 NY Slip Op 09604
Regular Panel Decision
Dec 29, 2015

Maggio v. 24 West 57 PFF, LLC

Plaintiff Joseph Maggio, a drywall installer, was injured after falling from a scaffold staircase at a premises owned by 24 West 57 APF, LLC and leased by Ana Tzarev New York, LLC (ATNY). The scaffold, constructed by Atlantic Hoist & Scaffolding, LLC, had a modified staircase with plywood covering some steps, lacking anti-slip protection and having an irregular rise. Plaintiff attributed his fall to these conditions and the presence of construction debris. The Supreme Court initially denied summary judgment motions from defendants 24 West and ATNY, citing outstanding discovery, and later denied renewed motions. On appeal, the Appellate Division found 24 West and ATNY justified in bringing the second motion but denied their request for summary judgment on negligence and Labor Law § 200 claims due to factual questions regarding notice of the dangerous condition. The court also denied plaintiff's untimely cross-motion for partial summary judgment on his Labor Law § 240 (1) claim. The Appellate Division modified the lower court's order, granting ATNY conditional contractual indemnification against R&R, and otherwise affirmed the decision.

Summary JudgmentLabor Law § 200Labor Law § 240 (1)Common-Law NegligenceContractual IndemnificationCommon-Law IndemnificationScaffold AccidentConstruction Site InjuryPremises LiabilityAppellate Procedure
References
12
Case No. ADJ1210556 (AGO 0018589)
Regular
Oct 10, 2008

EDWIN MILLER vs. KEEBLER COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition for removal and granted reconsideration of the WCJ's prior decisions regarding medical mileage and penalties. The Board found the WCJ failed to properly consider statutory factors in determining a "reasonable geographic area" for the applicant's medical treatment. Consequently, the WCAB rescinded the WCJ's decisions and returned the case to the trial level for further proceedings and a new decision addressing all outstanding issues, including the definition of a reasonable geographic area for treatment.

WCABPetition for RemovalPetition for ReconsiderationMedical MileageReasonable Geographic AreaLabor Code Section 4600Administrative Director Rule 9780(h)WCJBoltonRamirez
References
2
Case No. MISSING
Regular Panel Decision

Claim of Ford v. New York City Transit Authority

Claimant, a public relations director, filed for workers' compensation benefits in April 1994 due to work-related posttraumatic stress disorder, but later withdrew the claim in March 1997 due to a parallel federal civil rights action, leading to its closure without a decision on merits. In March 2003, claimant sought to reopen the case, which the Workers' Compensation Board denied in February 2004, citing Workers' Compensation Law § 123 as a bar. The Board subsequently denied an application for reconsideration and/or full Board review in July 2004, prompting the claimant's appeal. The appellate court affirmed the Board's decision, finding no new evidence was presented for reconsideration and that the Board had properly determined the claim was truly closed and time-barred under Workers' Compensation Law § 123, as over seven years had lapsed since the accident. Consequently, the appellate decision concluded that the Board's denial was not arbitrary, capricious, or an abuse of discretion.

Workers' Compensation AppealReconsideration DenialTime-Barred ClaimPosttraumatic Stress DisorderFederal Civil Rights ActionJurisdictionReopening ClaimMedical EvidenceDue ProcessWorkers' Compensation Law § 123
References
5
Case No. ADJ7697986
Regular
Oct 28, 2014

KIMBERLY RIVERA vs. VALLEY RADIOLOGY, SEABRIGHT INSURANCE

This Workers' Compensation Appeals Board decision affirms a prior finding that the defendant's utilization review (UR) was untimely. The Board found that even if the defendant received the request for treatment authorization on July 8, 2013, their subsequent UR denial dated July 15, 2013, was still untimely. The critical factor was the defendant's failure to provide initial communication of the denial via telephone, facsimile, or electronic mail, as required by Labor Code section 4610 and Administrative Director Rule 9792.9.1. Consequently, independent medical review was not appropriate, and the applicant's need for further medical treatment was upheld.

Utilization ReviewTimelinessLabor Code Section 4610Independent Medical ReviewRequest for AuthorizationPrimary Treating PhysicianFindings and AwardReconsiderationWCJIndustrial Injury
References
0
Case No. MISSING
Regular Panel Decision

Matter of Strujan v. New York Hospital

The case involves appeals from decisions of the Workers’ Compensation Board regarding a claimant's 1997 work-related injury. A claim for consequential psychiatric injuries was denied in 2010, and the employer sought to transfer liability to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a. While a WCLJ initially granted this transfer, the Board reversed, concluding the case was not 'truly closed' due to unresolved issues, including the claimant's alleged migraines. The court affirmed the Board's decision, finding substantial evidence to support that the case was not truly closed, thereby preventing the shift of liability to the Special Fund.

Workers' CompensationSpecial FundReopened CasesTrue ClosureLiability ShiftMigrainesPsychiatric InjuryConsequential InjuryBoard DecisionAppellate Review
References
9
Case No. MISSING
Regular Panel Decision

Claim of D'Addio v. Peter Annis, Inc.

A widow filed a claim for workers' compensation death benefits after her husband, who had an established claim for asbestosis, died. A Workers' Compensation Law Judge (WCLJ) found a work-related death and ordered the employer's carrier to deposit funds into the aggregate trust fund (ATF) in July 2010. The carrier did not appeal this initial decision. After a subsequent WCLJ decision in December 2010 reiterated the ATF deposit, the carrier sought review, arguing the deposit was unwarranted. The Workers' Compensation Board denied the carrier's application as untimely. The appellate court affirmed the Board's decision, holding that the 30-day appeal period for the July 2010 decision had expired and the later WCLJ decision did not extend that timeframe. The court found no abuse of discretion by the Board.

Workers' CompensationUntimely ApplicationAggregate Trust FundDeath BenefitsAsbestosisOccupational DiseaseAppellate ReviewBoard DiscretionTimelinessAppeal Denial
References
5
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